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[Federal Register Volume 79, Number 60 (Friday, March 28, 2014)]
[Notices]
[Pages 17542-17545]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-06880]

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 DEPARTMENT OF HEALTH AND HUMAN SERVICES

 Agency for Healthcare Research and Quality

 Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Agency for Healthcare Research and Quality, HHS.

ACTION: Notice.

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SUMMARY: This notice announces the intention of the Agency for 
Healthcare Research and Quality (AHRQ) to request that the Office of 
Management and Budget (OMB) approve the proposed information collection 
project: ``Evaluation of the Educating the Educator (EtE) Workshop.'' 
In accordance with the Paperwork Reduction Act of 1995, Public Law 104-
13 (44 U.S.C. 3506(c)(2)(A)), AHRQ invites the public to comment on 
this proposed information collection.

DATES: Comments on this notice must be received by May 27, 2014.

ADDRESSES: Written comments should be submitted to: Doris Lefkowitz, 
Reports Clearance Officer, AHRQ, by email at 
doris.lefkowitz@ahrq.hhs.gov.
    Copies of the proposed collection plans, data collection 
instruments, and specific details on the estimated burden can be 
obtained from the AHRQ Reports Clearance Officer.

FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ Reports 
Clearance Officer, (301) 427-1477, or by email at 
doris.lefkowitz@ahrq.hhs.gov.

SUPPLEMENTARY INFORMATION:

Proposed Project

Evaluation of the Educating the Educator (EtE) Workshop

    AHRQ's Educating the Educator (EtE) workshop training project is an 
Agency knowledge translation and dissemination project that aims to 
increase knowledge about and use of AHRQ's EHC Program products among 
health care professionals. For the EtE project, AHRQ is sponsoring the 
development of an accredited, in-person, train-the-trainer workshop 
program for health care professionals to educate them on how to use 
AHRQ's EHC Program materials and resources in shared decision making 
(SDM) with patients/caregivers. As a train-the-trainer program, the 
workshop also provides education on effectively training other health 
care professionals to facilitate the dissemination of the key 
competencies taught by the program. Additionally, as part of the EtE 
project, a collection of new stand-alone tools are being developed to 
facilitate the implementation and use of AHRQ EHC Program materials. 
The new tools will be integrated into the EtE workshop training program 
and made available to workshop participants. These new tools also will 
be publicly-accessible through the AHRQ Web site for easy referral, 
access, and use by both workshop participants and other health care 
professionals.
    AHRQ recognizes the importance of ensuring that its dissemination 
activities are useful, well implemented, and effective in achieving 
their intended goals. Therefore, an evaluation is associated with the 
EtE project. The EtE evaluation is comprised of two key components. One 
component has been designed to support both a process-oriented 
formative evaluation and a summative (impact) evaluation of the EtE 
train-the-trainer workshop program.

[[Page 17543]]

The other component is designed to assess the impact of new tools 
developed through this project in supporting the implementation of AHRQ 
EHC Program materials.
    The specific goals of the EtE train-the-trainer workshop evaluation 
(component 1) are to examine the following:
     Who is participating in both the primary train-the-trainer 
sessions, and in subsequent, secondary trainings offered by primary 
trainees?
     The uptake of and confidence among primary trainees in 
training others on the key competencies of the curriculum
     How the workshop implementation or course content should 
be modified to improve the quality of the training (e.g., instructor, 
materials, modules, etc.)?
     The extent to which workshop participants have been able 
to conduct additional trainings, start new PCOR education programs 
based on the workshop curriculum, or integrate the workshop curriculum 
into existing training programs in their local settings
     What the results of subsequent trainings by workshop 
participants were among secondary participants (i.e., individuals who 
received training from a workshop participant) in terms of their use of 
PCOR information and the practice of SDM with patients?
     Whether workshop participants have participated in other 
project activities, such as ongoing webinars or the learning network 
that are planned as part of the EtE project
     How workshop participants are using what they have learned 
from the training program in their own practice?
    The specific goals of the EtE new tools evaluation (component 2) 
are to examine the following:
     If and how workshop trainees and other health care 
professionals are using the new tools developed during this project to 
support their implementation of AHRQ EHC Program resources?
     How useful clinicians find AHRQ EHC Program resources to 
be in their practice?
     How frequently new tools are being accessed and used by 
workshop trainees and other health care professionals?
     Suggestions for improving tools to meet health care 
professionals' needs when serving their patients?
    This study is being conducted by AHRQ through its contractor, AFYA, 
Inc., and The Lewin Group, pursuant to AHRQ's statutory authority to 
support the agency's dissemination of comparative clinical 
effectiveness research findings. 42 U.S.C. 299b-37(a)-(c).

Method of Collection

    To achieve the goals of this project the following data collections 
will be implemented:
    (1) Pre-Training Survey of Primary Participants. This pen and paper 
survey will be administered to train-the-trainer workshop participants 
(also referred to as Primary Workshop Participants) immediately prior 
to the start of the in-person train-the-trainer workshop sessions. 
Information collected includes (1) non-identifying demographic 
information about respondents (e.g., type of clinician; practice 
setting); (2) participants knowledge of core concepts and objectives of 
the workshop; and (3) their confidence in training others. This 
instrument will also collect information about participants' use of and 
exposure to AHRQ EHC Program products for comparison at later time 
points.
    (2) Post-Training Survey of Primary Participants. This pen and 
paper survey will be administered to train-the-trainer workshop 
participants immediately following the conclusion of the in-person 
train-the-trainer workshop sessions. Information collected includes (1) 
post-training knowledge of core concepts presented in workshop; and (2) 
post-training confidence in training others. The post-training 
instrument will also collect information about participants' reaction 
to the training (e.g., instructor, the content, the presentation style, 
the schedule, etc.), a requirement for accreditation purposes.
    (3) Six-Month Post-Training Survey of Primary Participants. This 
survey will be administered to primary workshop participants six months 
following their participation in the train-the-trainer workshop. The 
survey will be Web-enabled, and a link to the survey will be emailed to 
participants. Information to be collected includes (1) behaviors and 
experiences of primary workshop participants in training others (i.e., 
secondary participants); (2) the numbers of individuals they have 
trained; and (3) barriers they have encountered in training others. 
This instrument will also collect (4) data on primary participants' 
early experiences in applying what they learned in the workshop 
training in their own clinical practice with patients; and (5) their 
use of AHRQ EHC resources and tools which will be compared to baseline 
measures.
    (4) One-Year Post-Training Survey of Primary Participants. This 
survey will be administered to primary workshop participants one year 
following their participation in the train-the-trainer workshop. The 
survey will be Web-enabled, and a link to the survey will be emailed to 
participants. This survey will collect the same information as 
collected in the 6-month survey. This instrument will also collect new 
information from participants about their use/participation in 
continued training that will be offered (e.g., participating in 
training and technical assistance webinars and the learning network 
that will be created).
    (5) One-Year Post Survey of Secondary Workshop Participants. This 
survey will be administered to secondary workshop participants one year 
following their receipt of continuing education (CE) credits for 
participating in locally-delivered workshops by primary workshop 
participants. The questions of interest include (1) non-identifying 
demographic information about respondents (e.g., type of clinician; 
practice setting); (2) their use of AHRQ EHC program products; (3) how 
useful they thought the training they received was in developing their 
patient engagement and SDM skills; (4) barriers they have encountered 
when implementing what they learned in practice; (5) the types of 
changes they or their organization have made related to involving 
patients in health care decision making and their use of decision 
support tools, since participating in the workshop; and (6) any changes 
that they have observed in their patients since they participated in 
the training.
    (6) New Tool Users. This survey will be deployed on the AHRQ Web 
site on a quarterly basis. More specifically, it will be made available 
on the new tools Web landing page on the AHRQ Web site so that it 
targets users of the new tools from this project. Information to be 
collected includes (1) non-identifying demographic information about 
respondents (e.g., type of clinician; practice setting); (2) whether or 
not they have participated in the workshop training associated with 
this project; (3) how often respondents use tools on the AHRQ tools 
landing page; and (4) how useful respondents find the tools to be and 
new tools that they would like to see added.
    AHRQ and the EHC Program staff will use the information collected 
through this Information Collection Request to assess the short- and 
long-term progress in achieving the dissemination and implementation 
aims of the EtE project. The information collected will facilitate 
real-time adjustments in the strategies and tactics that are used to 
promote and deliver the new tools and workshop training. The summative 
evaluation will assess the impact of this EtE workshop training program 
and new tools on

[[Page 17544]]

increased awareness, understanding, and use of AHRQ's EHC Program 
products in clinical practice with patients.
    The specific purpose and use of each of the data collection 
instruments is described below.
    (1) Pre- and Post-Training Surveys of Primary Workshop 
Participants--These data collections will be used to assess the 
effectiveness of the training in transferring course concepts to train-
the-trainer participants. They will be used to measure what 
participants learned during the training relative to their knowledge of 
core concepts and objectives of the workshop, and their confidence in 
training others as assessed prior to the training (pre-training 
survey). The pre-training survey also will establish a baseline level 
regarding workshop participants' use and exposure to AHRQ EHC Program 
products for comparison at later time points. The post-training 
assessment also will be used to assess workshop participants' reaction 
to the training. This is important for the process evaluation component 
of this project as it will provide information on participants' 
reactions to specific components of the program (e.g., instructor, the 
content, the presentation style, the schedule, etc.), a requirement for 
accreditation purposes, and help to identify where minor tweaking of 
the program may be needed to better meet participants' needs.
    (2) Six-Month Post-Training Survey of Primary Participants--This 
data collection will be used to assess the behaviors and experiences of 
workshop participants in training others (i.e., secondary 
participants), and whether the training has promoted changes to 
participants' use of PCOR resources in SDM with their patients. This 
survey will also be used to assess whether the use of AHRQ EHC Program 
products has increased since participating in the survey.
    (3) One-Year Post-Training Survey of Primary Participants--This 
data collection will be used to assess the long-term impact of the 
train-the-trainer workshop on participants' use of PCOR resources in 
SDM with patients in clinical practice. The assessment will determine 
if the training results in or contributes to changes in participants' 
continued use of key training concepts relative to baseline and 6-month 
assessments. This assessment also will provide information on the 
numbers of other individuals (i.e., secondary participants) who have 
received training at subsequent time points by the train-the-trainer 
workshop participants and the impact of training those secondary 
participants on their organizational practices regarding using AHRQ EHC 
Program products in SDM with their patients.
    (4) One-Year Post Training Survey of Secondary Workshop 
Participants--This data collection will be used to assess the 
effectiveness of the train-the-trainer format on disseminating 
knowledge among the health care community. The questions of interest 
include the following:
    [cir] Are participants from the train-the-trainer workshop able to 
effectively transfer or share key competencies from their training to 
other locally-based health care professionals (i.e., secondary 
participants)?
    [cir] Do secondary participants taught by AHRQ-sponsored train-the-
train workshop participants increase their use of AHRQ EHC Program 
products in SDM with their patients?
    (5) New Tool Survey--This data collection will be used to gather 
information on AHRQ Web site users experiences with the available new 
tools including who uses these tools and if they are useful.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated annualized burden hours for the 
respondents' time to participate in this evaluation. For the 
longitudinal evaluation, four questionnaires will be completed by 
approximately 1,500 primary trainees who participate in the AHRQ-
sponsored EtE train-the-trainer workshop, at the specified intervals, 
and each will require 10 or 15 minutes to complete. The annual survey 
of secondary participants will be completed by 3,000 secondary trainees 
(individuals who receive training from primary trainees) over the 3 
years. Based on previous experience with convenience-based Web-based 
surveys, we estimate that the quarterly Web-based survey of new tool 
users will be completed by approximately 1,200 respondents over the 3-
year period.
    Exhibit 2 shows the estimated annualized cost burden based on the 
respondents' time to participate in this project. The total cost burden 
is estimated to be $91,668.

                                  Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                     Number of
                    Form name                        Number of     responses per     Hours per     Total burden
                                                    respondents     respondent       response          hours
----------------------------------------------------------------------------------------------------------------
Pre-training survey (primary trainees) (time              * 1500               1           15/60             375
 point 1)..............................
Post-training survey (time point 2)....          * 1500               1           15/60             375
6-month post training survey (time point 60             250
 i>3)...........................................
12-month post training survey (time point 60             250
 i>4)...........................................
Annual survey (one-time survey of secondary                 3000               1           10/60             500
 trainees)......................................
Quarterly survey of new tool users..............            1200               1            5/60             100
                                                 ---------------------------------------------------------------
    Total.......................................        ** 5,700              NA              NA            1850
----------------------------------------------------------------------------------------------------------------
* These individuals are the same 1500 individuals (primary trainees) and will be assessed at four different time
  points.
** Estimated total number of unique respondents.

                                   Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
                                                     Number of     Total burden   Average hourly    Total cost
                    Form name                       respondents        hours        wage rate *       burden
----------------------------------------------------------------------------------------------------------------
Pre-training survey (primary trainees) (time                1500             375        * $49.55         $18,581
 point 1)..............................
Post-training survey (time point 2)....            1500             375         * 49.55          18,581
6-month post training survey (time point 3)...........................................
12-month post training survey (time point 4)...........................................
Annual survey (one-time survey of secondary                 3000             500         * 49.55          24,775
 trainees)......................................

[[Page 17545]]

 
Quarterly survey of new tool users..............            1200             100         * 49.55           4,955
                                                 ---------------------------------------------------------------
    Total.......................................        ** 5,700           1,850              NA          91,668
----------------------------------------------------------------------------------------------------------------
* Average hourly wage based on the weighted average of wages for 1 Family and General Practitioner (29-1062,
  $81.78), 1 Internist (29-1063, $86.20), 1 Physician Assistant (29-1071, $44.96), 1 Psychiatrist (29-1066,
  $95.33), 1 Nurse Practitioner (29-1171, $44.48), 3 Registered Nurses (29-1141, $34.23), 1 Pharmacist (29-1051,
  $59.87), 1 Licensed Practical or Licensed Vocational Nurse (29-2061, $21.17), 1 Health Educator (21-1091,
  $20.52), and 1 Administrative Services Manager (11-3011, $37.61). Data Source: National Occupational
  Employment and Wage Estimates in the United States, May 2012, ``U.S. Department of Labor, Bureau of Labor
  Statistics'' (available at http://www.bls.gov/oes/current/naics4_621400.htm).
** Estimated total number of unique respondents.

Request for Comments

    In accordance with the above-cited Paperwork Reduction Act 
legislation, comments on AHRQ's information collection are requested 
with regard to any of the following: (a) Whether the proposed 
collection of information is necessary for the proper performance of 
AHRQ health care research and information dissemination functions, 
including whether the information will have practical utility; (b) the 
accuracy of AHRQ's estimate of burden (including hours and costs) of 
the proposed collection(s) of information; (c) ways to enhance the 
quality, utility, and clarity of the information to be collected; and 
(d) ways to minimize the burden of the collection of information upon 
the respondents, including the use of automated collection techniques 
or other forms of information technology.
    Comments submitted in response to this notice will be summarized 
and included in the Agency's subsequent request for OMB approval of the 
proposed information collection. All comments will become a matter of 
public record.

    Dated: March 19, 2014.
Richard Kronick,
AHRQ Director.
[FR Doc. 2014-06880 Filed 3-27-14; 8:45 am]
BILLING CODE 4160-90-P
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